| NPI | 1578903936 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207RC0000X Internal Medicine, Cardiovascular Disease (Licence: CA A191070) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: MA 256337) |
| Enumeration Date | 2013-07-01 |
| Last Update Date | 2023-10-03 |